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CASE REPORT
Perilymphatic fistula and pneumolabyrinth without temporal bone fracture: a rare entity
  1. Ana Sousa Menezes,
  2. Daniela Ribeiro,
  3. Daniel Alves Miranda and
  4. Sara Martins Pereira
  1. Otorhinolaryngology - Head & Neck Surgery, Hospital de Braga, Braga, Portugal
  1. Correspondence to Dr Ana Sousa Menezes, ana4644{at}gmail.com

Abstract

Post-traumatic pneumolabyrinth is an uncommon clinical entity, particularly in the absence of temporal bone fracture. We report the case of a patient who presented to our emergency department with a headache, sudden left hearing loss and severe dizziness which began after a traumatic brain injury 3 days earlier. On examination, the patient presented signs of left vestibulopathy, left sensorineural hearing loss and positive fistula test, normal otoscopy and without focal neurological signs. The audiometry confirmed profound left sensorineural hearing loss. Cranial CT revealed a right occipital bone fracture and left frontal subdural haematoma, without signs of temporal bone fracture. Temporal bone high-resolution CT scan revealed left pneumolabyrinth affecting the vestibule and cochlea. Exploratory tympanotomy revealed perilymphatic fistula at the location of the round window. The sealing of defect was performed using lobule fat and fibrin glue. He presented complete resolution of the vestibular complaints, though the hearing thresholds remained stable.

  • ear, nose and throat/otolaryngology
  • otolaryngology/ent
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Footnotes

  • Contributors ASM takes full responsibility for the integrity of the data presented. DAM and SP contributed to the conception, analysis and interpretation of the data for the work. ASM and DR were responsible for the drafting of the manuscript and all the authors for revising it for important intellectual content.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Patient consent for publication Obtained.

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